Montana Basic Medicaid for Able-Bodied Adults

The Montana Basic Medicaid for Able-Bodied Adults (Basic Medicaid) is a statewide section 1115 Demonstration administered by the Montana Department of Public Health and Human Services (the State). The Basic Medicaid program began in 1996, under the authority of an 1115 welfare reform waiver referred to as Families Achieving Independence in Montana (FAIM). Under FAIM, Montana provided all mandatory Medicaid benefits and a limited collection of optional services to approximately 8,500 able-bodied adults (aged 21through 64 and neither pregnant nor disabled), who are parents and/or caretaker relatives of dependent children at or below the State Standard of Need (i.e., otherwise eligible for Medicaid under Sections 1925 or 1931 of the Social Security Act). The FAIM welfare reform waiver expired on January 31, 2004, and was replaced (without change) by a section 1115 Medicaid Demonstration, which was approved for the period of February 1, 2004 through January 31, 2009. The Demonstration was continued through a series of Temporary Extensions through November 30, 2010. On January 25, 2008, Montana proposed to renew the Basic Medicaid for Able-Bodied Adults Demonstration for eligible parents and caretaker adults and in subsequent communications proposed to expand eligibility using demonstration savings. On July 30, 2009 and August 13, 2010, the State submitted revised proposals to CMS. Under the revised proposals, Demonstration savings are used to provide Medicaid-like coverage to up to 800 individuals, aged 18 through 64, with incomes at or below 150 percent of the Federal poverty level (FPL), who have been diagnosed with a severe disabling mental illness (SDMI) of schizophrenia, bipolar disorder, or major depression, and who would not otherwise be eligible for Medicaid benefits. Prior to enrollment in the section 1115 Demonstration, these individuals received a very limited mental health benefit through enrollment in a State-financed Mental Health Service Plan (MHSP).